Miscellaneous Notices Respecting Cholera. 175 
_ “1, The disease essentially consists in this stage, in a determina- 
tion of fluids to the inner surface of the small intestines, diverting 
the respiratory, perspiratory and trinous discharges, with their neu- 
tral salts, from their usual channels; and discharging them through 
the intestinal exhalents, rapidly emptying the blood vessels of their 
contents, and changing the relative ee of the remnant of cir- 
culating fluids. — 
«2, That the failure of the functions of the heart, lungs, cnpllliny 
circulation, and various secretions, results from direct depletion, de- 
priving those organs of their accustomed stimulus. 
“3, The absorbent system is rapidly taking up the adipose and 
waste parts of the body, to supply the failing resources of the heart, 
— Pee results the rapid emaciation. 
. The spasms of the voluntary muscles, sid those drawn into 
apt in the act of vomiting, by compressing the intestinal ex- 
halents, tend to arrest the discharges; and by aiding the return of 
the venous circulation, stimulate the heart to redoubled exertion, 
giving a centrifugal direction to the circulation, thereby making a 
metastasis of the axhaletine from the inner surface of the bowels to — 
skin. 
“5, That a striking wage ® exists ates this disease and he= 
morrhage, differing only in its effects upon the constitution, from the 
circumstance of its changing the relative proportions of the ingredi- 
ents of the blood.” 
From this summary it will be seen that Dr. Spencer const the 
exhalent tissue of the intestinal canal to be the proximate seat of the 
disease, and to the restoration of this tissue to the healthy perform- 
ance of its functions, his remedies are directed. ‘The indications 
which he lays down for the treatment of the second stage of the dis- 
ease, will convey a just view of the remedial measures which he re- 
commends. 
These indications are, 
“1, To arrest the intestinal discharge. 
2, To make a transfer of the serous discharges from the sitheleate 
of the bowels to those of the external surface. 
3, To restore the lost balance and healthy performance of the va- 
rious excretory and secretory functions. 
‘4, To reupport the powers of the a and combat incidental 
symptoms.” 
